Midwifery, Internationally
For the past couple of weeks we have had the delightful presence of a 22-year-old male midwife from Britain. He has just finished his three-year degree program in Liverpool and came to San Diego for a clinical rotation to observe the culture of midwives in the United States. Because we are at war with the medical profession rather than in collaboration, it's a very, very different culture here!
Today was Ben's last day with us (we're all totally in love with him - he's the sweetest guy imaginable), and he spent the whole morning giving a presentation on the British midwifery system. It took awhile because we kept interrupting in total shock about how their system works. It was a time of sharing and comparing and talking about the best ways to serve women. He craves the more holistic approach that we use, where we offer intensive nutritional counseling first, then move to herbs and Chinese medicine, then finally if needed turn to Western medicine and possibly transfer to a physician if necessary. They don't really do a lot of nutritional counseling nor do they study Chinese medicine or homeopathy to the same extent that we do. In return, however, midwives are the standard of care of Britain. It was just amazing. Here are the facts that astounded and/or heartened me the most:
1) Every single pregnant woman in GB is assigned a midwife. If the midwife needs a consult, she will bring in a doctor to consult on the case, but even then the midwife is considered the primary care provider throughout the pregnancy. Imagine that. Imagine a world where every woman has her midwife, has access to a care provider who will come to her home to do prenatal checks and to deliver her child.
2) Midwives are a part of the NHS, which means that their services are free independent of the mother's economic status.
3) Midwives are required by law to collaborate with other healthcare professionals, as well as teachers and social workers, to troubleshoot women's health and wellness issues.
4) Midwives can work with equal authority in the hospital setting or at home without sacrificing their autonomy. Here, if a mother needs additional care from a hospital, then the midwife transfers her to a physicians' care, and those physicians will usually try to keep the midwife away from the laboring woman. In GB, there isn't a power struggle, because in the end it is the midwife who is the primary practitioner. When the doctor is no longer needed, he/she leaves and the midwife resumes care.
Midwives in Great Britain are much more medicalized than we are here in the States, but a large part of this is because they are so integrated into the system. Like I said, they envy our ability to function outside the medical system, but we envy their acceptance by other healthcare providers as educated and valuable contributors.
A midwife from Quebec City, Quebec, was also visiting today, and she reflected that the Canadian system is very much like GB.
The United States may have "the best healthcare in the world," but we are (I believe) 52nd in the world with regards to maternal and infant perinatal mortality. In other words, we come right after Slovenia on the list of countries in the world where it's safest to have a baby. We have worse outcomes for women than many third-world countries.
Let's change that. Every woman deserves a midwife.
Today was Ben's last day with us (we're all totally in love with him - he's the sweetest guy imaginable), and he spent the whole morning giving a presentation on the British midwifery system. It took awhile because we kept interrupting in total shock about how their system works. It was a time of sharing and comparing and talking about the best ways to serve women. He craves the more holistic approach that we use, where we offer intensive nutritional counseling first, then move to herbs and Chinese medicine, then finally if needed turn to Western medicine and possibly transfer to a physician if necessary. They don't really do a lot of nutritional counseling nor do they study Chinese medicine or homeopathy to the same extent that we do. In return, however, midwives are the standard of care of Britain. It was just amazing. Here are the facts that astounded and/or heartened me the most:
1) Every single pregnant woman in GB is assigned a midwife. If the midwife needs a consult, she will bring in a doctor to consult on the case, but even then the midwife is considered the primary care provider throughout the pregnancy. Imagine that. Imagine a world where every woman has her midwife, has access to a care provider who will come to her home to do prenatal checks and to deliver her child.
2) Midwives are a part of the NHS, which means that their services are free independent of the mother's economic status.
3) Midwives are required by law to collaborate with other healthcare professionals, as well as teachers and social workers, to troubleshoot women's health and wellness issues.
4) Midwives can work with equal authority in the hospital setting or at home without sacrificing their autonomy. Here, if a mother needs additional care from a hospital, then the midwife transfers her to a physicians' care, and those physicians will usually try to keep the midwife away from the laboring woman. In GB, there isn't a power struggle, because in the end it is the midwife who is the primary practitioner. When the doctor is no longer needed, he/she leaves and the midwife resumes care.
Midwives in Great Britain are much more medicalized than we are here in the States, but a large part of this is because they are so integrated into the system. Like I said, they envy our ability to function outside the medical system, but we envy their acceptance by other healthcare providers as educated and valuable contributors.
A midwife from Quebec City, Quebec, was also visiting today, and she reflected that the Canadian system is very much like GB.
The United States may have "the best healthcare in the world," but we are (I believe) 52nd in the world with regards to maternal and infant perinatal mortality. In other words, we come right after Slovenia on the list of countries in the world where it's safest to have a baby. We have worse outcomes for women than many third-world countries.
Let's change that. Every woman deserves a midwife.